| Popis: |
Introduction: Implant-prosthetic rehabilitation of patients with a free fibula graft is today more the rule than the exception, as it was 20 years ago. Today, the reconstruction of the entire masticatory and stomatognathic system, after mutilating operations of patients in the orofacial region, is considered standard. Placing dental implants in the fibula osteofasciocutaneous flap (OSCFFF) represents a special clinical challenge in implantology because, due to the structural diversity, drilling in OSCFFF can be demanding, and it is often difficult to achieve the primary stability of the implant. Since patients requiring OSCFFF represent a therapeutically demanding group of patients, even when osseointegration of the implant is achieved, long-term satisfactory oral rehabilitation is not easy to achieve. Material and methods: The aim of this presentation is to show the advantages and importance of pre- surgical planning in patients who need medium facial reconstruction using OSCFFF. We present patients with OSCFFF in follow-up from 4 to 21 years with a presentation of the importance of interdisciplinary cooperation between maxillofacial surgeons, oral surgeons and prosthetists. Results: In all patients after 4 - 21 years, satisfactory functionality and aesthetics of the implant reconstruction in the OSCFFF graft were observed. Conclusion: OSCFFF represents a valuable technique for large facial reconstructions. After placement of dental implants in a jaw reconstructed with OSCFFF, the period of osseointegration sometimes needs to be extended to nine to twelve months. Vestibuloplasty is recommended before placing prostheses. Placing dental implants in OSCFFF represents a valuable solution for this group of patients. |
